| NPI | 1770522153 | 
|---|---|
| Doing Business As | OSCO DRUG #0960 | 
| Entity Type | Organization | 
| Authorized Contact | KATHY GIANNAKOPOULOS Enrollment Manager 208-395-3954  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AZ Y04562)  | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies | 
| 333600000X Pharmacy | |
| Enumeration Date | 2006-06-04 | 
| Last Update Date | 2020-04-03 |